T29-27918-59388
3 vaccinations
6 coded responses
17 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 606 / IL
- Registered
- 2022-10-19
- Relationship
- Child or adolescent in my care
- Guardian
- 5NV-24851-33134
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2022-09-26
Dose 1 — Moderna
-
2022-10-19
Registered in v-safe
- 2022-10-19
-
2022-11-03
Dose 2 — ModernaCo-administered: Flu
-
2022-11-03
Health check-in — day 0, dose 2, under 3Feeling: Good · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-11-04
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-11-05
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Redness · Fever · Irritability/crying, DiarrheaUnder 3 check-in
-
2022-11-08
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Good · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-11-19
Survey response — day 14, dose 2, under 3MedDRA: Conjunctivitis, Ear infection, Irritability — Feeling: Fair · Be unable to work or attend schoolFree text: Double pink eye, ear infection, cold and irritable.MedDRA releases: 2024-11 · check-in free text available
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2022-11-24
Survey response — day 21, dose 2, under 3MedDRA: Ear infection, Pyrexia, Urticaria — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fever, ear infection, full body hivesMedDRA releases: 2024-11 · check-in free text available
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2022-12-01
Survey response — day 28, dose 2, under 3MedDRA: Conjunctivitis, Cough, Ear infection, Lethargy, Pyrexia, Roseola — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Roseola, pink eye, 104 fever, ear infection, lethargic, and wet coughMedDRA releases: 2024-11 · check-in free text available
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2022-12-01
Report sent to call center — day 28, dose 2, under 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2022-12-02
Call successfulParticipant prefers to complete VAERS report online
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2022-12-10
Survey response — day 35, dose 2, under 3MedDRA: Cough — Feeling: GoodFree text: Long cough at nightMedDRA releases: 2024-11 · check-in free text available
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2022-12-16
Survey response — day 42, dose 2, under 3MedDRA: Cough, Rhinorrhoea — Feeling: GoodFree text: Still coughing and runny noseMedDRA releases: 2024-11 · check-in free text available
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2023-02-02
Survey response — 3 months, dose 2, under 3MedDRA: Pyrexia — Feeling: Poor · Be unable to work or attend schoolMedDRA releases: 2024-11
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2023-03-15
Dose 3 — ModernaCo-administered: Hepatitis A:MMR:Pneumonia
-
2023-03-23
Health check-in — day 7, dose 3, under 3Feeling: Fair · Fever · Sleepiness, Irritability/crying, Loss of appetiteUnder 3 check-in
- 2023-04-05
- 2023-04-12
- 2023-04-19
- 2023-04-26
- 2023-06-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-26 | Moderna | No |
| 2 | 2022-11-03 | Moderna | Flu |
| 3 | 2023-03-15 | Moderna | Hepatitis A:MMR:Pneumonia |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-01 | Successful 2022-12-02 |
Participant prefers to complete VAERS report online |
Free text
Release 12 (Under 3) — day 14, dose 2, under 3
Symptoms: Double pink eye, ear infection, cold and irritable.
Release 12 (Under 3) — day 21, dose 2, under 3
Symptoms: Fever, ear infection, full body hives
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Roseola, pink eye, 104 fever, ear infection, lethargic, and wet cough
Release 12 (Under 3) — day 35, dose 2, under 3
Symptoms: Long cough at night
Release 12 (Under 3) — day 42, dose 2, under 3
Symptoms: Still coughing and runny nose
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Conjunctivitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Irritability | · | · | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Roseola | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release